NUR 300 Lecture Notes - Lecture 3: Granuloma, Cardiac Output, Gingivitis
Document Summary
Horizontal mobility is greatest at the 4th to 5th cervical vertebrae. Drains lymph from the rest of the body into the left subclavian. Deep nodes lie under the muscle and fascia: present illness. Radon or radium treatment around head and neck. Surgery for tumor: past medical history, thyroid dysfunction, personal and social. Watch as patient swallows: sl hyperextension, symmetry of sternocleidomastoid and trapezius, alignment of trachea, anterior and posterior triangles, masses, webbing, fullness, asymmetry. Thyroid gland: inspect, palpate, jvd, carotid artery distension, identity structures. Thyroid isthmus: just below, fingers on either trachea have pt swallow, tug may mean aortic aneurysm. Examining for size, shape, consistency, nodules, tenderness, vascular sounds. Smooth, pliant (capable of being bent), glandular non tender. Gritty or more tender may be inflammation. Record shape (irregular vs regular: usually not palpable in healthy adults. Small, mobile, discrete, shotty < 1 cm. less concern: pals, palpable supraclavicular node is herald node for thoracic or abdominal.
